title: Technical challenges in TIPS creation via the right subclavian vein.
abstract: This report describes a 64-year-old man with Laennec cirrhosis requiring a transjugular intrahepatic portosystemic shunt (TIPS) to alleviate ascites before surgical mesh repair of a large symptomatic umbilical hernia. During the procedure, both internal jugular veins and the right external jugular vein were found to be occluded. The right subclavian vein was accessed and a TIPS was successfully created. Some of the technical challenges encountered in performing the procedure from the right subclavian vein are described.
authors.affiliation: Department of Radiology, University of Medicine and Dentistry of New Jersey-New Jersey Medical School, H108, University Hospital, 150 Bergen Street, Newark, NJ 07101, USA.
authors.forename: Sohail G
authors.initials: SG
authors.lastname: Contractor
authors.forename: Alex
authors.initials: A
authors.lastname: Merkulov
authors.forename: Pranay C
authors.initials: PC
authors.lastname: Uppuluri
authors.forename: Waseem
authors.initials: W
authors.lastname: Bhatti
authors.forename: Tej
authors.initials: T
authors.lastname: Phatak
mesh_terms: D001201:Ascites / Q000209:etiology / Q000601:surgery*; D006554:Hernia, Umbilical / Q000150:complications / Q000601:surgery; D006801:Humans; D007601:Jugular Veins / Q000000981:diagnostic imaging / Q000503:physiopathology; D008103:Liver Cirrhosis / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D010690:Phlebography; D019168:Portasystemic Shunt, Transjugular Intrahepatic; D013350:Subclavian Vein / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014654:Vascular Patency